Patient-Associated Predictors of 15- and 30-Day Readmission After Hospitalization for Acute Heart Failure

• Published in: Current heart failure reports 2019-12, Vol.16 (6), p.304-314
• Main Authors: Delgado, Juan F., Ferrero Gregori, Andreu, Fernández, Laura Morán, Claret, Ramón Bascompte, Sepúlveda, Andrés Grau, Fernández-Avilés, Francisco, González-Juanatey, José R., García, Rafael Vázquez, Otero, Miguel Rivera, Segovia Cubero, Javier, Pascual Figal, Domingo, Crespo-Leiro, Maria G., Alvarez-García, Jesús, Cinca, Juan, Ynsaurriaga, Fernando Arribas
• Format: Article
• Language: English
• Subjects: Cardiac Surgery; Cardiology; Decompensated Heart Failure (P Banerjee; Imaging; Internal Medicine; Medicine; Medicine & Public Health; Radiology; Section Editor; Topical Collection on Decompensated Heart Failure; Vascular Surgery
• ISSN: 1546-9530; 1546-9549
• DOI: 10.1007/s11897-019-00442-1

Background Identifying readmission predictors in heart failure (HF) patients may help guide preventative efforts and save costs. We aimed to identify 15- and 30-day readmission predictors due to cardiovascular reasons. Methods and Results A total of 1831 patients with acute HF admission were prospectively followed during a year. Patient-associated variables were gathered at admission/discharge and events during follow-up. A multivariate Fine and Gray competing risk regression model and a cumulative incidence function were used to identify predictors and build a risk score model for 15- and 30-day readmission. The 15- and 30-day readmission rates due to cardiovascular reasons were 7.1% and 13.9%. Previous acute myocardial infarction, congestive signs at discharge, and length of stay > 9 days were predictors of 15- and 30-day readmission, while much weight loss and large NT-ProBNP reduction were protective factors. The NT-ProBNP reduction was larger at 30 days (> 55%) vs 15 days (> 40%) to protect from readmission. Glomerular filtration rate at discharge < 60 mL/min/1.73m 2 and > 1 previous admissions due to HF were predictors of 30-day readmission, while first post-discharge control at an HF unit was a protective factor. Conclusions Previous identified factors for early readmission were confirmed. The NT-ProBNP reduction should be increased (> 55%) to protect from 30-day readmission.